Factors Affecting the LGBT Population When Choosing a Surrogate Decision Maker

ABSTRACT

For individuals in the marginalized population of lesbian, gay, bisexual, and trans- gender persons (LGBT), choosing a health care surrogate to make medical decisions is an emotionally challenging task. These decisions become more difficult when compounded by issues of discrimination, lack of legal and social support, varying levels of relationship commitment, and complications of disclosure to family and medical professionals. Limited research exists regarding the social, legal, medical, and familial environments that impact the choice of a surrogate decision maker for an LGBT individual. This systematic review examines 14 articles to identify factors influencing individual surrogate choice and existing gaps in the literature. To remedy current research limitations, future research recommendations address the areas of design, sampling, data collection, and data analysis within diverse subgroups of the LGBT population. This review further identifies related areas of service required by members of the LGBT population relative to diversity, demographics, and social, legal, medical, and familial environments influencing their choice of a surrogate decision maker.     

Predicting Career Indecision in College Students: The Roles of Identity Formation and Parental Relationship Factors

Students' identity formation and perceptions of parental acceptance and encouragement of independence were investigated as predictors of career indecision. The Mother-Father-Peer Scale (Epstein, 1983), Extended Objective Measure of Ego Identity Status (Bennion & Adams, 1986), and Career Decision Scale (Osipow, Carney, Winer, Yanico, & Koschier, 1976) were administered to 169 undergraduate students with a mean age of 19.68. Analysis using multiple regression indicated that career indecision was predicted by a greater degree of identity moratorium and diffusion, less maternal acceptance and fewer years in college. Suggestions for future research and counseling applications are provided.     

Age at placement and adult adopted people's experience of being adopted

Older age at placement has long been recognized as a risk factor in successful adoption outcomes. The findings of the present study emerged as part of a larger study that looked at the adoption experiences and reunion outcomes of 472 adults who had either searched for or been sought by one or more of their birth relatives. As part of the investigation, adopted adults were asked to evaluate their adoption experience. Age at placement was used as a key variable in examining whether or not adopted people felt different to their adoptive family, felt they belonged in their adoptive family, and felt loved by their adoptive parents while growing up. Respondents were also asked to evaluate their overall experience of being adopted. Older age at placement significantly increased the risk of adopted people viewing major aspects of their adoption experience with either mixed or negative feelings.     

A GENOGRAM WITH AN ATTITUDE

The approach described in this paper is predicated on the fundamental belief that in order to become competent and ethical practitioners, students must understand themselves and how they see others. They must be given tools and skills that facilitate examinations of their own assumptions and beliefs about themselves, other, and how the world works. It is also essential that students examine how these assumptions and beliefs will influence the way they choose to conduct therapy. Once they are aware of their biases, they must learn to choose to consciously influence themselves in a way that permits their clients the largest room for change within the clients' own contexts of belief, understanding, experience, and possibility. In this paper I describe the use of the genogram as a tool to facilitate the process of gaining self knowledge. This tool has been used in a multicultural counseling course, as well as in professional development workshops for psychologists, mental health counselors, and marriage and family therapists.     

Ein theoretisches Modell zur Integration von Arbeitsmigranten in Organisationen

This article in the journal “Gruppe. Organisation. Interaktion. (GIO)” portraits a model of organizational acculturation that describes the emergence of acculturative and socialization stressors upon the encounter of different cultures when migrant workers enter organizations, while taking into account the perspective of persons already employed in those organizations. This model combines approaches of acculturation and socialization research. Intrapersonal (cyclic interplay of information, uncertainty reduction and learning) and interpersonal (voice, participation, empowerment and social support) coping-processes lead to successful adaptation of work migrants. In turn, successful adaptation has positive effects on further work-related outcomes. The model takes account of the fact that due to the additional challenge of having to adapt to a new culture, organizational socialization of work migrants proceeds in a more complex fashion. The model provides starting points for future research and practical applications.     

Women With Hypoactive Sexual Desire Disorder Versus Sexual Interest/Arousal Disorder: An Empirical Test of Raising the Bar

In 2013, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published with a major revision to the sexual dysfunction categories, and the diagnosis of female hypoactive sexual desire disorder (HSDD) was replaced with female sexual interest/arousal disorder (SIAD). Since being introduced, concern has been expressed that SIAD inappropriately “raises the bar” for diagnosis. To address these concerns, we sought to evaluate the number of women with a diagnosis of HSDD who also met criteria for SIAD. In a sample of 151 women, we found that 73.5% of women with a diagnosis of HSDD met criteria for SIAD. The two groups were compared on the Sexual Interest/Desire Inventory, and women who met criteria for both HSDD and SIAD consistently scored lower on sexual desire frequency and satisfaction, satisfaction with sex, receptivity, positive sexual thoughts, reactions to erotica, arousal frequency, ease, continuation, and orgasm ease/achievement, and higher on distress. In addition, women meeting criteria for HSDD only tended to have mild symptoms across the six SIAD criteria compared to those meeting criteria for both HSDD and SIAD. These findings suggest that the SIAD criteria does not unduly raise the bar for diagnosis.     

Caregiver‐endorsed strategies to improving sexual health outcomes among foster youth

Foster youth are at an increased risk of unintended pregnancies and sexually transmitted infections (STIs) compared with peers. We conducted 11 semistructured focus groups with 86 foster and kinship caregivers in three child welfare jurisdictions to understand their strategies for monitoring and communicating with youth in foster care around sexual health topics, with the overall goal of developing a training for caregivers to reduce STI and unintended pregnancies among youth in foster care. We used thematic analysis to analyse the data. Three main themes emerged: (1) strategies to communicate with youth about sexual health (trust‐building, open/direct communication, tailoring information to each individual youth, creative conversation‐starters, and self‐education), (2) strategies for monitoring youth (e.g., tailoring monitoring to youth development/characteristics, clearly communicating rules, co‐development of rules, spending time with youth/friends/friends' parents, using technology, using a social support system), and (3) other strategies to promote positive youth development (advocating for youth, engaging youth in goal‐setting). Trainings that provide caregivers with (1) information on sexual health and normal adolescent development and (2) strategies and skills to help caregivers engage in open, evidence‐informed communication, and monitor youth in a tailored, developmentally‐informed manner are likely to improve reproductive health and other outcomes among youth in foster care.